Clumsy? Put Away the Band-Aids and Take Out the Mind-Aids

Everyone trips, stumbles, or otherwise suffers a self-imposed accidental injury at least once in a while. However, some people seem to be constantly wearing Band-aids while others sail through life with nary a scrape. Some of the accident-free still find that once in a while even they slip and fall, particularly when they’ve got a lot on their mind. Is it stress or something more enduring about a person that causes these unfortunate outcomes?

As I write this blog, I look down at my right hand which has a very slowly-recovering blackened thumb nail (from a brief but now painful interaction with a door) and a scar on the palm (from missing the bottom step in a two-step “flight” of stairs). These encounters with immovable objects, one of which required a doctor’s visit, led me to reflect on the nature of accident-proneness. Why did these silly mishaps occur at this particular juncture in my life? Do my occasional slips make me different in some ways from people who never open the bandage box in their medicine cabinets? Do they reflect a generally careless approach to life or are situational factors such as work stress the real culprit?

Given how commonly people fall prey to those minor bumps and bruises, the topic of accident proneness is relegated, surprisingly, to some pretty remote corners of psychology. Sigmund Freud believed that there’s no such thing as a true accident. Not only do we unconsciously try to punish ourselves can be diagnostic, revealing particular areas of our bodies that we’re trying to damage or destroy. As with many of Freud’s ideas, these were intriguing suggestions but not readily amenable to empirical study. Instead, researchers focusing on clumsiness investigated its origins in childhood attention disorders or as occupying a place on the autism spectrum, establishing a lifelong behavioral pattern of inability to pay attention to our surroundings.

Obviously, though, many more people have accidents in adulthood than do those who have a diagnosable attention deficit or autism spectrum diagnosis. Though not beyond the threshold needed to receive a psychiatric diagnostic process, it’s possible that the accident-prone nevertheless suffer a lower-grade, chronic inattentiveness to their environments that keep them from seeing those bottom steps, slippery spots on the floor, or danger lurking at the edge of a tomato slicer. The British experimental psychologist Donald Broadbent believed that the tendency to experience cognitive failures is a quality that we carry with us throughout life. The more our minds are prone to these failures, the less protected we’ll be against these environmental dangers. To test people’s mental accident proneness, Broadbent developed a brief self-report measure, the appropriately-named “Cognitive Failures Questionnaire,” or CFQ.

See how you rate on these sample CFQ items:

1. Do you fail to notice signposts in the road*

2. Do you bump into people?

3. Do you fail to notice people's names when you are meeting them?

4. Do you forget where you put something like a newspaper or book?

5. Do you find you forget appointments?

6. Do you drop things?

7. Do you fail to hear people speaking to you when you are doing something else?

8. Do you say something and realize afterwards that it might be taken as insulting?

The more you agree with these items, the more mentally accident-prone you are.

Broadbent’s work started to bring order to the field of workplace accidents, an area of study within fields such as occupational medicine and industrial productivity. In one of the largest and most recent investigations, Groningen University Center psychiatrist Ellen Visser and a team of researchers reported on their findings from 79 empirical studies on nearly 150,000 people, representing a total of over 250,000 accidents, most of which required medical attention. As they reported in the journal Accident Analysis and Prevention, Visser compared, the clustering of accidents in individuals is statistically higher than would be expected by chance alone. In other words, there really are accident-prone individuals in the population. However, their analysis did not permit them to understand what the unique features are that characterize these emergency room regulars because they had no access to the type of psychological accident-proneness that so intrigued Broadbent. In fact, the zeitgeist in the workplace accident field tended to discount individual vulnerabilities in favor of pointing to flawed environmental precautions that would protect workers against injury.

Broadbent’s notion of cognitive failures began to resurface, however, within the past decade or so and were finally put to the test on a large scale by a British team of environmental scientists led by Andrea J. Day, published several years later in Accident Analysis and Prevention. According to Day and her colleagues, because people high in CFQ have impaired perception, action, and memory capabilities, they will be particularly likely to have accidents when their mental resources are stretched to the limit, particularly the kind that results from workplace stress. Preoccupied with such personal issues as work-family conflict, feeling overworked, or being dissatisfied with the physical conditions of their workplace, people prone to cognitive lapses have particular difficulty focusing on what’s going on around them.

Day and her team tested the idea that people given to attentional lapses when stressed at their workplace are the most vulnerable to accidental injuries on a group of 56 British Royal Navy sailors matched with their non-accident prone counterparts and studied over a 2-year period. The sailors were drawn from a sample of their peers who completed questionnaires assessing stress, defined as their tendency to report experiencing symptoms of anxiety and depression. As predicted, the stressed sailors were significantly more likely to have accidents than the non-stressed. Their accidents consisted primarily of attentional lapses, such as bumping into things and falling down hatches. However, stress became an insignificant factor when CFQ scores were entered into the equation.

One might argue that people given to mental lapses experience higher levels of stress and therefore have more accidents. However, because CHQ scores show a high degree of stability over time and stress scores do not, Day and her colleagues maintained that the cognitive failures are at the heart of the problem for the accident prone. They are more distracted when stressed, and their so-called “executive,” or decision-making abilities are unable to withstand the pressure caused by work-related conflict.

As you reflect on your own history of bumps and bruises or, like me, are inspecting a few that you’ve recently acquired, Day’s research may give you little solace. After all, you have only yourself and your attentional frailty to blame. However, the results should also provide you with some encouragement. Knowing your vulnerability can be the first step to bolstering yourself mentally against the possible psychological, if not physical, dangers in your environment, and not just at work.

The good news is, then, that you don’t need to be resigned to a lifetime of clumsiness. Cognitive failures are really another form of mindlessness in which you carry out actions without being aware of what you’re doing. In mindfulness training, you learn to focus your mental energy on your actions, allowing you to perform even routine tasks with greater deliberation and effectiveness. Mindfulness training is also an excellent form of relaxation and can also cut your levels of stress. With practice, you’ll find that your cognitive failures are outweighed by your successes, and you can put those Band-aids away for good.

"Poor muscle tone, poor motor control, delays in gross and fine motor development and coordination, failure to develop and perfect basic motor skills and lack of physical coordination" can result from neglect, from malnutrition or from repeatedly being hit in the head or shaken as an infant or minor child.

I think the studies about adults who are physically clumsy should include interviews or investigations into the individual's background; I'm willing to bet that chronically clumsy adults have some form of organic brain damage or inner-ear injury, and that in a certain percentage of cases this was caused by parental/primary caregiver abuse or neglect throughout the individual's formative years.